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RK Dental Care

RK Dental Care

Fairfax Dentist - Fair Oaks Dentist - Dr. Komal Karmacharya

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Patient Forms

Welcome to RK Dental family. We are so glad you have chosen us and are trusting us with your dental care needs. You can now conveniently complete registration forms in advance of your appointment using the link below.

Link to Patient Registration Packet

Alternatively, you can also print the forms below and fill out to bring in to your first appointment. Thank you and we are looking forward to seeing you soon.

  • Patient Registration Form
  • Medical History Form
  • Dental History Form
  • Dental Insurance Form
  • Financial Agreement Form
  • HIPAA Form

Policy Documents

For reference, below are our office Policy documents:

Notice of Privacy Practices

Appointment Cancellation Policy

Online Payment

We have an online payment option for our existing patients. Click here to make an online credit card payment. Please be sure to include your email address if you would like a receipt of the payment sent to your email.

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